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DOCUMENT 00420 <br />INFORMATION REQUIRED FROM BIDDERS <br />GENERAL INFORMATION <br />The Bidder shall furnish the following information. Failure to comply with this requirement may cause <br />its rejection. Additional sheets shall be attached as required. f <br />1. Provider's Name /Address: P1� `�' <br />2. Provider's Telephone Number: S <br />3. Provider's License: E —Ito 2 <br />Primary Classification: C--IM ) 6ne4)Q6 <br />4. Number of years as a Provider in construction work of the type involved in this Contract: <br />5. List the names and titles of all officers of Provider's firm: <br />�K �� -h2 �r'res�� <br />1 <br />Vi <br />E <br />Name of person who inspected site or proposed work for your firm: <br />Name: �f <br />Date of Inspection: <br />What is the last project of this nature you have completed? <br />Have you ever failed to complete work awarded to you; if so, where and why? <br />P3. <br />05/06 00420 -1 03-4122.E <br />